Vulnerability assessment of health care facilities during disaster events

Infrastructure systems are essential to the operation of health care facilities and do not exist in isolation of one another-telecommunications networks require electricity, transportation networks require systems information to operate, emergency systems require transportation networks, and so forth. During a disaster event, health care facilities are expected to operate efficiently to provide sufficient care to injured patients. However, medical care for injured patients can be affected if health care facilities do not have a sufficient supply of electricity, water, access to road transportation networks, etc. This paper presents a methodology to assist in the analysis of the operational vulnerability of a health care facility during disaster events, considering the impact of disruption of a selected number of critical infrastructure systems in the flow of patients. It integrates the analysis of external infrastructure systems and the internal capabilities of the facility. The analysis of external infrastructure systems is performed using mathematical models that use optimization techniques to determine the unsatisfied demand in the major infrastructure systems and the impact of this shortage of resources on the operation of the hospital. A system dynamics simulation model is used to represent the internal operation of the health care facility, including the interaction between the different service areas, the flow of patients within the facility, and the condition of the external infrastructure systems that supply its resources. The framework and modeling presented in this paper can assist in determining cost-effective operational strategies in a health care facility that better respond to disaster events because they consider the interdependencies between infrastructure systems.